Provider Demographics
NPI:1619972924
Name:HIGBEE, SHIRLEY A (RN, NPC)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:A
Last Name:HIGBEE
Suffix:
Gender:F
Credentials:RN, NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 OLD NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9611
Mailing Address - Country:US
Mailing Address - Phone:609-652-1526
Mailing Address - Fax:
Practice Address - Street 1:640 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-9602
Practice Address - Country:US
Practice Address - Phone:609-567-9003
Practice Address - Fax:609-567-9269
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07726500363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7294630Medicaid
NJ7294630Medicaid
HI950501Medicare ID - Type Unspecified